A PROSPECTIVE, CROSS - SECTIONAL STUDY OF 15,000 SOUTH INDIAN CHILDREN ASSESSING COMPETENCY OF THE BROSELOW-LUTEN PEDIATRIC RESUSCITATION TAPE Dr. Srihari Cattamanchi,* Postgraduate Resident, MD (A&EM), Department of Accident & Emergency Medicine, Sri Ramachandra Medical University, Porur – 600 116. Chennai. T.N, India
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ASSESSING COMPETENCY OF THE BROSELOW-LUTEN PEDIATRIC RESUSCITATION TAPE - A PROSPECTIVE, CROSS - SECTIONAL STUDY OF 15,000 SOUTH INDIAN CHILDREN
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A PROSPECTIVE, CROSS - SECTIONAL STUDY OF 15,000 SOUTH INDIAN CHILDREN
ASSESSING COMPETENCY OF THE BROSELOW-LUTEN PEDIATRIC
RESUSCITATION TAPE
Dr. Srihari Cattamanchi,*Postgraduate Resident, MD (A&EM),Department of Accident & Emergency Medicine,Sri Ramachandra Medical University,Porur – 600 116. Chennai. T.N, India
BACKGROUND
No standardized methods available for rapid weight estimation in children admitted for acute pediatric emergencies in Chennai, India.
The Broselow tape has shown to improve accuracy in weight prediction and eliminate the need for memorization and calculation in Emergency situations.
AIMS & OBJECTIVES
To determines the accuracy of the Broselow pediatric emergency tape in the Indian pediatric population.
To find out the standard deviation of Weight from Broselow pediatric emergency tape to Indian population.
To determine the usefulness of Broselow pediatric emergency tape in Indian Settings.
METHODS
Design: A prospective, cross-sectional study
Population: 15,000 South Indian children in three weight-based groups of >10 kg, 10-18 kg and <18 kg.
Duration: 2 months, September 15th 2008 to November 15th 2008.
Setting: The data was collected from children attending Sri Ramachandra Pediatric OPD and ED in tertiary care hospitals in Chennai, and also from 16 different schools in and around Chittoor municipality, in South India.
METHODS
Proforma: Age, sex, height, actual weight, & Broselow weight were recorded in a preformatted Performa.
Analysis: Measured weight was compared to Broselow predicted weight and percent difference was calculated. A cross – validated correction factor was derived by non linear regression. Analysis done using SPSS Ver. 15.0.
BROSELOW-LUTEN ZONES
Zone CM Length Kg Weight Age months0 Grey < 59.5 3 – 5 < 21 Pink 59.5-66.5 6-7 2-5
2 Red 66.5-74 8-9 5-11
3 Purple 74-84.5 10-11 11-19
4 Yellow 84.5-97.5 12-14 19-30
5 White 97.5-110 15-18 30-39.5
6 Blue 110-120.75 19-23 39.5-62.5
7 Orange 120.75-133.424-29 62.5-83
8 Green 133.4-146.5 30-36 83-107.5
PINKRED
PURPLE
YELLOW
BLUE
ORANGE
GREEN
WHITE
The Broselow-Luten SystemColor Wall Chart- Height
METHODOLOGY
Inclusion criteria: Children above 2 months of age and below 12 years of age were be eligible to participate in this study.
Exclusion: Severely Malnourished children & child with chronic illness.
RESULTS
AGE & SEX DISTRIBUTION
0 1 2 3 4 5 6 7 8 9 10 11 120
200
400
600
800
1000
1200
1400
1600
1800
Male
Age in Years
No
of C
hild
ren
DISTRIBUTION ACCORDING TO HEIGHT
Distribution According To Weight.
Comparison of Broselow’s & Actual Weight
n = 15,000
Results..
• The mean percentage differences were – 2.4 +6.3, and -17.9% for each weight-based group.
• The Broselow color-coded zone Std. dev was 16.12, 11 & 24.5 in their respective group.
USEFULLNESS OF BROSELOW’S TAPE
Pediatric drugs
Defibrillator settings
Infusion Pumps
Ventilator Settings
C.Spine Collar Size
Medications
PALS
Rapid Sequence Intubation
Anaphylaxis
Pain and Sedation
Fluids and burns
Seizures & electrolyte correction
Oral Antibiotics
BROSELOW-LUTEN ZONES
Zone CM Length Wt in Kg Age in months0 Grey < 59.5 3 – 5 < 21 Pink 59.5-66.5 6-7 2-5